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Thread: Diabetes & General ICD-9 coding rules

  1. #1
    Join Date
    Apr 2007

    Default Diabetes & General ICD-9 coding rules

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    The final impression states:
    1) Diabetes type II, uncontrolled
    2) Nephropathy: Microalbuminuria, hypertension
    3) Macrovascular: Hyperlipidemia
    4) Neuropahy: Peripheral, hypoglycemia unawareness

    Now the codes the Provider coded on the charge ticket are:
    1) 250.02
    2) 250.42
    3) 401.9
    4) 272.4
    5) 250.62

    It has always been my understanding according to the ICD-9-CM coding guidelines that unless the Provider specifically states "diabetic nephropathy" or "Diabetic periperheral neuropathy" that you can not code it as a diabetic related complication from categories 250.1X -250.9X.

    I would code as follows according to the documentation of the final impression:
    1) 250.02
    2) 583.9
    3) 791.0
    4) 401.9
    5) 272.4
    6) 356.9
    7) 251.2

    Does anyone agree/disagree? Am I wrong in my interpretation of the guidelines?

    I would appreciate any and all feedback.
    Thank you

  2. #2


    I would have coded exactly as you did or queried the provider to link the manifestations to diabetes. Your interpretation of the guidelines is correct! The provider would need a statement such as "Nephropathy due to diabetes" or "diabetic nephropathy" in order to support 250.42. We have gone through external audits and this is one area the providers have been heavily educated on. We were told that DM documentation was a common area for errors.

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